Medicare covers mobility scooters, but only under specific conditions

Medicare Part B will pay for a mobility scooter if your doctor prescribes it as medically necessary and you meet the coverage rules. Medicare calls a mobility scooter a "motorized wheelchair" or "power-operated vehicle" (POV). The program does not pay for any scooter you want — it pays only when a scooter is the right tool for a medical condition that limits your ability to walk, and when you have tried other options first.

The catch is that Medicare's rules are strict, and many people are denied the first time they request one. Understanding what Medicare actually requires before you ask your doctor for a prescription can save you months of back-and-forth.

Key Takeaways

  • Your doctor must write a prescription stating that a mobility scooter is medically necessary for your specific condition, not just that you have trouble walking.
  • Medicare requires that you have tried a cane or walker first and that these tools did not work well enough for you to move around safely at home.
  • You must be able to operate the scooter safely — Medicare will not pay if you cannot steer, brake, or understand how to use it.
  • Medicare pays 80 percent of the approved amount after you meet your Part B deductible; you pay the remaining 20 percent, unless you have a Medigap or Medicare Advantage plan that covers it.
  • You must purchase the scooter from a Medicare-enrolled supplier, not from a private seller or a store that does not bill Medicare directly.

What Medicare requires before it will pay

Medicare has four main requirements. First, your doctor must document that you have a condition that limits your ability to walk — arthritis, Parkinson's disease, stroke recovery, spinal cord injury, or similar diagnoses. The condition itself is not enough; your doctor must also document that the condition prevents you from walking safely inside your home without help.

Second, you must have tried a cane or walker and found that it does not work for you. Medicare does not require that you own one, but your doctor's notes should show that you and your doctor discussed why a cane or walker would not be safe or practical. If you have never tried one, your doctor may ask you to try it for a few weeks before prescribing a scooter.

Third, your doctor must state that you can operate a scooter safely. This means you can understand the controls, steer it, brake it, and use it without falling or injuring yourself. If you have cognitive decline, severe vision loss, or problems with your hands or arms, Medicare may deny the request on these grounds.

Fourth, your doctor must write that the scooter is for use primarily inside your home. Medicare will not pay for a scooter meant for outdoor use or travel. If you need a scooter for both, you may need to show that indoor mobility is the main reason.

How to start the process with your doctor

Call your doctor's office and ask to discuss a mobility scooter. Do not assume your doctor will know to prescribe one; many doctors are not familiar with Medicare's rules and may not think to suggest it. When you call, be specific about what you cannot do: "I cannot walk from my bedroom to the kitchen safely" is more useful to your doctor than "I have trouble walking."

At your appointment, your doctor will examine you and ask about your daily activities. Bring a list of the things you cannot do safely without help — getting to the bathroom, moving around the kitchen, going to the mailbox. Your doctor will document this in your medical record and then decide whether to write a prescription.

If your doctor agrees, ask for a written prescription that includes the medical reason for the scooter. The prescription should say something like "motorized wheelchair for indoor mobility due to [your condition]." Your doctor may also need to fill out a form called a Certificate of Medical Necessity (CMN). Ask your doctor's office whether they will complete this form or whether you need to have the supplier do it.

Finding a Medicare-enrolled supplier and ordering

You must buy the scooter from a company that is enrolled with Medicare. You cannot buy one from Amazon, a local medical supply store that does not bill Medicare, or a private seller and then ask Medicare to reimburse you. Medicare will not pay in those cases.

To find an enrolled supplier, use the Medicare Supplier Directory at dmepos.cms.gov. Enter your ZIP code and search for "motorized wheelchair" or "scooter." The directory will show you which suppliers in your area are enrolled with Medicare. Call at least two suppliers and ask what models they have, what the Medicare-approved amount is, and what you will owe out of pocket.

When you order, give the supplier your prescription and your Medicare number. The supplier will submit the paperwork to Medicare for you. Do not pay the full cost upfront; the supplier should bill Medicare first. You will owe your 20 percent coinsurance only after Medicare approves and pays its share.

What Medicare pays and what you pay

Medicare sets an approved amount for each type of scooter. The approved amount varies by region and by the specific model. Medicare pays 80 percent of the approved amount; you pay 20 percent. You must also have met your Part B deductible for the year (the deductible amount changes each year).

Example: If the Medicare-approved amount for a scooter is $1,000 and you have already met your deductible, Medicare pays $800 and you pay $200. If you have not met your deductible, you pay the deductible amount first, and then Medicare pays 80 percent of what is left.

If you have a Medigap plan or a Medicare Advantage plan, your coinsurance may be covered in full or in part. Check your plan documents or call your plan to find out what you will owe before you order.

What happens if Medicare denies your request

If Medicare denies your request, the supplier will send you a notice called an "Explanation of Benefits" (EOB). The notice will say why Medicare denied it — for example, "medical documentation does not support medical necessity" or "beneficiary can ambulate safely with assistive device."

You have the right to appeal. You have 120 days from the date on the EOB to file an appeal. The first level of appeal is called a "redetermination." You or your doctor can submit new medical information, a letter from your doctor explaining why the denial was wrong, or additional documentation of your condition.

If the redetermination is also denied, you can request a second level of appeal called a "reconsideration." At this stage, an independent reviewer who did not make the first decision will look at your case. Many people succeed at the reconsideration level because they have had time to gather better documentation.

Renting versus buying

Medicare will pay for you to rent a scooter instead of buying one. The rental payment goes toward the purchase price if you later decide to buy. Rental may be a good option if you are not sure you will use the scooter long-term or if you want to try one before committing to a purchase.

Ask the supplier about both rental and purchase options and what Medicare will pay for each. Some suppliers offer a trial period — usually 30 days — so you can make sure the scooter works for you before Medicare processes the purchase.

Questions to ask your doctor and supplier

Ask your doctor: "Do you think a mobility scooter would help me move around my home safely?" If yes, ask: "Will you write a prescription and complete the Certificate of Medical Necessity form?" If your doctor is unsure, ask what additional information or trial period might help them decide.

Ask the supplier: "Are you enrolled with Medicare?" "What is the Medicare-approved amount for this model?" "What will I owe out of pocket?" "How long does Medicare approval usually take?" "Do you offer a trial period?" "Will you submit the paperwork to Medicare, or do I need to?"

Frequently Asked Questions

Can I buy a scooter myself and ask Medicare to pay me back?

No. Medicare will not reimburse you for a scooter you bought on your own, even if you have a prescription. You must purchase from a Medicare-enrolled supplier so the supplier can submit the claim to Medicare before you pay.

What if I live in an apartment and cannot keep a scooter there?

Medicare requires that the scooter be for use in your home. If you cannot store it safely in your apartment, talk to your doctor about whether a cane or walker might work instead, or whether you might use the scooter at a facility you visit regularly, like a senior center or medical office.

Does Medicare pay for a scooter if I only need it for outdoor activities?

No. Medicare covers scooters only for indoor home mobility. If you need a scooter primarily for outdoor use or travel, Medicare will not pay. You would need to purchase one privately or look into other funding sources.

How long does it take Medicare to approve a scooter?

Approval typically takes two to four weeks if all paperwork is complete and correct. If Medicare needs more information from your doctor, it can take longer. Ask the supplier for an estimate based on their experience in your area.

What if my doctor says I do not need a scooter?

If your doctor does not think a scooter is medically necessary, Medicare will not pay for one. You can ask your doctor to explain their reasoning and whether there are other options. You can also seek a second opinion from another doctor, but that doctor would also need to agree that a scooter is medically necessary.